The Racial Representation of Cosmetic Surgery Patients and Physicians on Social Media

Abstract Background Aggregated data shows that Black patients receive disproportionately lower rates of cosmetic surgery than their Caucasian counterparts. Similarly, our lab has shown that social media representation is lower among Black patients for breast reconstruction surgery, and we expect that this could be the case in cosmetic surgery as well. Objectives In this study, we explore the social media representation of Black patients and physicians in the five most common cosmetic surgery procedures: rhinoplasty, blepharoplasty, abdominoplasty, breast augmentation, and liposuction. Methods We collected data from RealSelf (Seattle, WA), the most popular social media site for sharing cosmetic surgery outcomes. Our lab assessed the skin tone of 1000 pictures of patients in each of the top five cosmetic surgeries according to the Fitzpatrick scale, a commonly utilized skin tone range. Additionally, we gathered Fitzpatrick scores of 72 providers who posted the photos within each surgical category. Results We found that Black patients and providers are underrepresented in rhinoplasty, blepharoplasty, breast augmentation, and liposuction compared to the general population (defined by the US Census Bureau) while being proportionately represented in abdominoplasty. Additionally, we found that patients most often matched Fitzpatrick scores when both had scores of two, while patients with a score of five and six rarely matched their provider’s score. Conclusions We suspect that the underrepresentation of Black patients and providers in social media for cosmetic surgery discourages patients from pursuing cosmetic surgeries. Therefore, it is essential to properly represent patients to encourage patients interested in considering cosmetic surgery.